REVIEW article
Front. Aging Neurosci.
Sec. Parkinson’s Disease and Aging-related Movement Disorders
This article is part of the Research TopicParkinson Disease: Current findings and challenges in diagnosing and treating motor and non-motor symptomsView all 17 articles
Neuropsychological Aspects of Impulse Control Disorders in Parkinson's Disease
Provisionally accepted
- Innsbruck Medical University, Innsbruck, Austria
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Impulse control disorders (ICDs), such as excessive gambling, compulsive sexual behaviour, binge eating, compulsive shopping as well as punding, and the dopamine dysregulation syndrome, may arise as a debilitating neuropsychiatric complication in Parkinson's disease (PD). Although the pathophysiology is not fully understood, it likely involves mesolimbic dopaminergic overstimulation combined with disease-related vulnerabilities in reward, motivation, and inhibitory control networks. This narrative review summarizes evidence on the neuropsychological, affective, and behavioural traits associated with ICDs in PD, with a particular focus on epidemiology/clinical manifestations, neurobiological and pharmacological mechanisms, as well as prevention and management strategies. ICDs can affect up to 40% of PD patients and are strongly associated with dopamine agonist exposure, younger age of onset, premorbid personality traits, and neuropsychiatric comorbidities. Neuropsychological findings reveal abnormalities in several domains, including reflection impulsivity, temporal discounting, novelty seeking, risk processing, and inhibitory control, while mood disorders, sleep dysfunction, apathy, and anxiety further influence vulnerability and worsen behavioural dysregulation. Although general awareness for development of ICDs has been raised, they still represent a significant burden for patients and their family members and are a predictor of functional decline and lower quality of life. Management includes dopamine agonist withdrawal, the cessation of fast acting dopaminergic agents and treatment of neuropsychiatric comorbidities. In selected cases, deep brain stimulation or continuous dopaminergic delivery should be considered, particularly in those experiencing persistent worsening of motor symptoms despite appropriate adjustment of dopaminergic medication.
Keywords: Binge eating, Compulsive sexual behaviour, Compulsive shopping, dopamine dysregulation syndrome, Excessive gambling, Inhibitory Control, Novelty seeking, Parkinson's disease
Received: 15 Dec 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Scanferla and Djamshidian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Atbin Djamshidian
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